本文選題：七氟醚 + 缺血-再灌注損傷��； 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：目的探討七氟醚對(duì)急性腎缺血-再灌注損傷腎功能的保護(hù)作用。 方法選擇健康SD大鼠90只，，隨機(jī)分為三組：偽手術(shù)組（A組），對(duì)照組（B組）及七氟醚預(yù)處理組（C組），建立腎臟缺血-再灌注模型,對(duì)照組和七氟醚預(yù)處理組實(shí)驗(yàn)大鼠用10％水合氯醛0.3ml/100g腹腔注射，游離左右腎蒂，夾閉腎蒂阻斷腎臟血流45min后解除夾閉，使血流再通，缺血-再灌注損傷模型建立成功后，分別測定各組大鼠平均動(dòng)脈壓（MAP）、二氧化碳分壓(PCO2)、血清尿素氮（BUN）、肌酐（Cr）、超氧化物歧化酶(SOD)及胱抑素C(CysC)的變化，HE染色觀察各組大鼠腎組織病理改變。所得數(shù)據(jù)采用SPSS13.0統(tǒng)計(jì)學(xué)軟件分析，P＜0.05有統(tǒng)計(jì)學(xué)意義。 結(jié)果隨著七氟醚預(yù)處理濃度逐漸增加，大鼠的平均動(dòng)脈壓呈逐漸下降的趨勢(shì)，但在七氟醚濃度為2%-3%的臨床常用劑量范圍內(nèi)，大鼠的MAP波動(dòng)于92.1±6.0mmHg。各組缺血前與再灌注后，PCO2濃度沒有明顯的差異。B組和C組BUN、Cr于再灌注后4h、12h、24h均明顯高于A組（P＜0.05），但C組同一時(shí)間點(diǎn)的BUN、Cr水平均較B組明顯下降（P＜0.05）。C組和B組均較A組血清SOD活力明顯減低（P＜0.05），但C組SOD活力較B組高，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。腎臟病理觀察發(fā)現(xiàn)：A組腎臟組織結(jié)構(gòu)完整，B組腎臟外髓部分組織結(jié)構(gòu)嚴(yán)重破壞，而C組腎臟組織破壞較小，腎小管組織相對(duì)較為完整。本次試驗(yàn)中選取實(shí)驗(yàn)動(dòng)物血清胱抑素C(Cystatin C，Cys C)的變化作為反應(yīng)對(duì)腎臟缺血-再灌注保護(hù)作用的指征。與偽手術(shù)組相比，對(duì)照組、七氟醚預(yù)處理組的血清胱抑素C均明顯升高（P〈0.05）；與對(duì)照組相比，七氟醚預(yù)處理組的血清胱抑素C水平有所降低（P〈0.05）。 結(jié)論七氟醚吸入式麻醉能夠有效降低BUN、Cr、CysC水平，升高血清SOD活力，從而對(duì)急性腎缺血-再灌注損傷腎功能具有一定的保護(hù)作用。
[Abstract]:Objective to investigate the protective effect of sevoflurane on renal function after acute renal ischemia-reperfusion injury. Methods 90 healthy SD rats were randomly divided into three groups: sham operation group (group A), control group (group B) and sevoflurane preconditioning group (group C) to establish renal ischemia-reperfusion model. In the control group and sevoflurane pretreatment group, 10% chloral hydrate (0.3ml/100g) was injected intraperitoneally to free the left and right renal pedicles, and the renal pedicle was blocked by blocking the renal blood flow (45min), then the blood flow was re-opened, and the model of ischemia-reperfusion injury was established successfully. The mean arterial pressure (MAPP), carbon dioxide partial pressure (CO 2), bun (bun), creatinine (Cr), superoxide dismutase (SOD) and cystatin CysC (Cy CysC) were measured respectively. The pathological changes of renal tissue in each group were observed by HE staining. The data were analyzed by SPSS 13.0 software (P < 0.05). Results with the increase of preconditioning concentration of sevoflurane, the mean arterial pressure of rats decreased gradually, but the map of rats fluctuated at 92.1 鹵6.0 mmHg in the range of 2 to 3% of the concentration of sevoflurane. There was no significant difference in the concentration of PCO _ 2 between groups before ischemia and after reperfusion. The level of bun Cr in group B and group C was significantly higher than that in group A at 4 h after reperfusion (P < 0.05), but the level of bun Cr in group C at the same time point was significantly lower than that in group B (P < 0.05) and group B (P < 0.05). The serum SOD activity of group A was significantly lower than that of group A (P < 0.05), but the activity of SOD in group C was higher than that in group B. The difference was statistically significant (P < 0.05). The pathological observation of kidney showed that the renal tissue structure was intact in group A and the structure of extramedullary tissue in group B was serious, while that in group C was less than that in group C. the renal tubular tissue was relatively intact. The changes of cystatin Cystatin Cys Cys in serum of experimental animals were selected as the indication of the protective effect of cystatin Cystatin Cys on renal ischemia reperfusion. Compared with the sham operation group, the serum cystatin C level in the sevoflurane preconditioning group was significantly higher than that in the control group (P < 0.05), and the serum cystatin C level in the sevoflurane preconditioning group was lower than that in the control group (P < 0.05). Conclusion sevoflurane inhaled anesthesia can effectively reduce the level of CysC and increase the activity of SOD in serum, which can protect renal function from acute renal ischemia-reperfusion injury.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R614

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